Distribution of Clinical Staphylococccus aureus Isolates and Antibiotic Resistance Profile: Three-Year Data

Yıl 2022, Cilt: 12 Sayı: 6, 984 - 988, 30.11.2022

Ali Korhan Sığ , Alev Çetin Duran , Tuğba Kula Atik , Nermin Özen , Onur Irmak , Muradiye Yarar

https://doi.org/10.16899/jcm.1082385

Cited By: 2

Öz

Objective: Staphylococci cause community-acquired and hospital-acquired infections, and Staphylococcus aureus is one of leading agents. In the last decades methicillin-resistant S.aureus (MRSA), vancomycin-intermediate S.aureus (VISA) and vancomycin-resistant S.aureus (VRSA) became as major concerns. Resistance to other antibiotics is also another growing issue. The aim of this study was to investigate the prevalence of S.aureus species and to evaluate susceptibilities to antimicrobial agents in a state (tertiary) hospital.
Methods: Clinical cultures from various samples (urinary tract, respiratory, wound, abscess, tissue, catheter and external auditory) obtained from January 2017 to December 2019 in XXX hospital were included in the study. Isolated S.aureus strains and their antibiotic susceptibilities were retrospectively evaluated.
Results: A total of 765 S.aureus strains were isolated. 165 S.aureus strains were found as methicillin resistant (MRSA; 21.9%). There was not any statistically significant difference in MRSA rates among evaluated years (p=0.772). There was not any strain that was resistant to vancomycin, teicoplanin and/or linezolid. The highest rate was observed in penicillin resistance (n=646/728, 88.7%). There was not any statistically significant alteration in the resistance rates of all tested antibiotics during the three-year period.
Conclusions: Despite dwindling MRSA rates in UAMDSS, CAESAR report indicates that Turkey seems to be in the beginning phase of this struggle. Local and/or national antimicrobial stewardship programs are in effect in Turkey, but further measures are required.

Anahtar Kelimeler

staphylococci, methicillin, MRSA, EUCAST, CLSI

Teşekkür

The authors wish to declare special thanks to İlkay BIÇAK, M.D. and Osman KILINÇ, M.D. (Atatürk City Hospital, Department of Medical Microbiology, Balikesir, Turkey) for their precious support.

Klinik örneklerden izole edilen Staphylococcus aureus izolatlarının sıklığı ve antibiyotik duyarlılık sonuçlarının değerlendirilmesi: Üç Yıllık Veri

Öz

Amaç: Stafilokoklar hem toplum hem de hastane kaynaklı enfeksiyonlara neden olabilmektedir ve Staphylococcus aureus bu cinste en başta gelmektedir. Son yıllarda, metisilin dirençli S.aureus (MRSA), vankomisine orta düzeyde duyarlı S.aureus (VISA) ve vankomisine dirençli S.aureus (VRSA) suşları ciddi bir sorun olarak ortaya çıkmışlardır. Diğer antibiyotiklere karşı artan direnç de ayrı bir sorundur. Bu çalışmadaki amaç, üçüncü basamak bir hastanede çeşitli klinik örneklerden izole edilen S.aureus suşlarının sıklığını ve antibiyotik duyarlılıklarını araştırmaktır.
Yöntem: Çeşitli klinik örneklerin (üriner sistem, solunum, yara, apse, doku, katater ucu ve dış kulak yolu) Ocak 2017'den Aralık 2019'a kadar XXX hastanesindeki kültürleri çalışmaya dahil edilmiştir. Üremiş S.aureus suşları ve antibiyotik duyarlılıkları geriye dönük araştırılmıştır.
Bulgular: Toplamda 765 S.aureus suşu izole edilmiştir ve bunların 165 tanesi metisilin dirençlidir (MRSA; %21.9). Yıllara göre MRSA oranları arasında istatistiksel fark bulunamamıştır (p=0.772). Vankomisin, teikoplanin ya da linezolid e dirençli bir suşa rastlanmamıştır. En yüksek direnç oranı penisilinlere karşı bulunmuştur (n=646/728, %88.7). Üç yıllık dönemde antibiyotik direncinde hiçbir antibiyotik için anlamlı fark gözlenmemiştir.
Sonuç: UAMDSS verilerine göre azalan MRSA oranları gözlensede, CAESAR raporu Türkiye'nin daha mücadelenin başında olduğuna işaret etmektedir. Yerel ve/veya ulusal antimikrobiyal yönetimi programları Türkiye'de de aktiftir, ancak daha sert ve geniş önlemlere ihtiyaç vardır.

Anahtar Kelimeler

stafilokoklar, metisilin, MRSA, EUCAST, CLSI

Kaynakça

• Tong SY, Davis JS, Eichenberger E, Holland TL, Fowler VG Jr. Staphylococcus aureu sinfections: Epidemiology, pathophysiology, clinical manifestations, and management. Clin Microbiol Rev 2015; 28(3): 603-661.
• Lee AS, de Lencastre H, Garau J, Kluytmans J, Malhotra-Kumar S, Peschel A, Harbarth S. Methicillin-resistant Staphylococcus aureus. Nat Rev Dis Primers 2018; 4: 18033.
• Gardete S, Tomasz A. Mechanisms of vancomycin resistance in Staphylococcus aureus. J Clin Invest 2014; 124(7): 2836-2840.
• McGuinness WA, Malachowa N, DeLeo FR. Vancomycin Resistance in Staphylococcus aureus. Yale J Biol Med 2017; 90(2): 269-281.
• European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 9.0, Basel, Switzerland. https://www.eucast.org [Date of Access: 15 June 2021].
• David MZ, Daum RS. Treatment of Staphylococcus aureus Infections. In: Bagnoli F, Rappuoli R, Grandi G. (eds) Staphylococcus aureus. Current Topics in Microbiology and Immunology, vol 409. Springer, Cham, 2017. https://doi.org/10.1007/82_2017_42
• Centers for Disease Control and Prevention (CDC). Antibiotic Resistance Threats in the United States, 2019. Atlanta, GA: U.S. Department of Health and Human Services, CDC; 2019. DOI: http://dx.doi.org/10.15620/cdc:82532.
• https://www.who.int/news/item/27-02-2017-who-publishes-list-of-bacteria-for-which-new-antibiotics-are-urgently-needed (Date of Access: 17 June 2021).
• Turner NA, Sharma-Kuinkel BK, Maskarinec SA, et al. Methicillin-resistant Staphylococcus aureus: an overview of basic and clinical research. Nat Rev Microbiol 2019; 17(4): 203-218.
• World Health Organization (WHO). Central Asian and European Surveillance of Antimicrobial Resistance (CAESAR), Annual 2020 Report, 2020. https://www.euro.who.int/__data/assets/pdf_file/0003/469200/Central-Asian-and-European-Surveillance-of-Antimicrobial-Resistance.-Annual-report-2020-eng.pdf (Date of Access: 17 June 2021).
• https://hsgm.saglik.gov.tr/tr/uamdss (Date of Access: 17 June 2021).
• Mataj V, Guney M, Sig AK, et al. An Investigation into bacterial bloodstream infections and antibiotic resistance profiles in a tertiary hospital for a ten-year period. Clin Lab 2020; 66: 1467-1477.
• Gandra S, Mojica N, Klein EY, et al. Trends in antibiotic resistance among major bacterial pathogens isolated from blood cultures tested at a large private laboratory network in India, 2008–2014. Int J Infect Dis 2016; 50: 75-82.
• Cusack TP, Ashley EA, Ling CL, et al. Impact of CLSI and EUCAST breakpoint discrepancies on reporting of antimicrobial susceptibility and AMR surveillance. Clin Microb Infect 2019; 25(7): 910-911.
• Isler B, Keske Ş, Aksoy M, et al. Antibiotic overconsumption and resistance in Turkey. Clin Microb Infect 2019; 25(6): 651-653.